Incidentally Detected Gallbladder Carcinoma: Can F-18 FDG PET/CT Aid in Staging and Prognostication?

Autor: Krishnaraju VS; Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Kumar R; Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Mittal BR; Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Singh H; Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Aggarwal P; Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Singh H; Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Yadav TD; Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Nada R; Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Gupta V; Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India., Gupta R; Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Jazyk: angličtina
Zdroj: Nuclear medicine and molecular imaging [Nucl Med Mol Imaging] 2024 May; Vol. 58 (3), pp. 104-112. Date of Electronic Publication: 2024 Jan 25.
DOI: 10.1007/s13139-024-00841-w
Abstrakt: Purpose: Incidental gallbladder carcinoma (IGBC) is diagnosed in post-cholecystectomy specimens for benign indications, where the role of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography(FDG-PET/CT) is not clearly defined. The present study aimed to assess the benefits of staging and prognosticating with FDG-PET/CT in IGBC.
Materials and Methods: A retrospective observational study from a tertiary-care center from January 2010 to July 2020 was performed. The demographic, clinical, histopathological, and treatment-related histories were collected. FDG-PET/CT-image findings were compared with survival outcomes through telephonic follow-up. The chi-square test was used for comparing frequencies. The univariate and multivariate survival estimates were analyzed using the Kaplan-Meier analysis and the Cox-proportional hazard model, respectively. Log-rank test was used to compare the Kaplan-Meier curves.
Results: The study included 280 postcholecystectomy participants (mean age: 52 ± 11 years; women: 227) of whom 52.1% had open surgery(146/280). Residual disease in the gallbladder fossa (54.8% vs. 36.6%, p  = 0.002) and liver infiltration (32.9% vs. 22.4%, p  = 0.05) were seen more frequently in open surgery compared to laparoscopic surgery, while anterior abdominal wall deposits were more common in laparoscopy(35.1% vs. 24%, p  = 0.041). FDG-PET/CT changed the management in 10% ( n  = 28) of patients compared to contrast-enhanced CT. The median survival was 14 months (95%CI-10.3-17.7). A higher stage of the disease on the FDG-PET/CT (loco-regional disease-HR 4.86, p  = 0.006; metastatic disease-HR 7.53, p  < 0.001) and the presence of liver infiltration (HR-1.92, p  = 0.003) were independent predictors of poor survival outcomes.
Conclusion: FDG-PET/CT detects residual and metastatic disease in patients with IGBC, enabling the institution of appropriate management and acting as a tool for prognostication of survival.
Competing Interests: Competing InterestsVenkata Subramanian Krishnaraju, Rajender Kumar, Bhagwant Rai Mittal, Harjeet Singh, Piyush Aggarwal, Harmandeep Singh, Thakur Deen Yadav, Ritambhra Nada, Vikas Gupta, and Rajesh Gupta declare that they have no competing interest.
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Databáze: MEDLINE
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